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10 Cards in this Set
- Front
- Back
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s/s of hypothyroid
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lethargy
weight gain hair loss DRY skin depression slowed mentation forgetfulness weakness cold intolerance constipation fluid retention abnormal menses |
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s/s of hyper thyroid
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nervous
tremor palpitations fatigue difficulty concentrating weight loss heat intolerance increase DB freq/diarrhea on PE: tachy, incr SBP, exophthalmus, muscle weakness, sudden paralysis, dependent edema |
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what is the management of a thyroid nodule
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if the TSH is elevated and it is palpable --> US
If the US is suspicious --> FNA |
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Differential dx for depressed mood after pregnancy + thyroid nodule
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thyroiditis: Hashimotos or postpartum
hypopituitarism/central hypopit depression: postpart, situational thyroid ca prolactinoma toxic nodule hypothyroidism anemia |
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what labs do you order for depressed mood after preg/ thyroid nodule
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CBC
CMP UA TSH/ T3 / Free T4 antithyroid peroxidase antibody |
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What is the Levothyroxine regimen and when to F/U
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0.125mg/day
F/U in 4 weeks and then Q4weeks until therapeutic |
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When to F/u if placing someone on antidepressants
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2 wks
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What educational issues are important with levothyroxine
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it works slowly - can take a couple of months to see results
take on an empty stomach - at least 30 min before meals take 8 hrs apart from antacids or iron preparations can lead to flushing,anxiety, or increased BP Can cz decreased bone density, may want to supplement Ca++ |
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What is the F/U for a benign thyroid nodule
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repeat US in 1yr
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What is the education for someone with a thyroid nodule in terms of when they should call office/present to ED
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hoarseness
cough hemoptysis pain at neck dysphagia dyspnea |
